通过持续质量改进项目,减少学生运营的免费诊所的患者访问时间
Miranda J Reid1, Ethan Kramer2, Alexandria Iakovidis2
1Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, USA.
Cureus
|September 9, 2024
概括
在一个由学生经营的免费诊所 (SRFC) 中实施持续质量改进 (CQI) 周期,使患者访问的时间减少了12%. 关键的改进重点是优化患者接收流程和临床流程,增强患者体验.
科学领域:
- 医疗保健管理的管理
- 提高质量 提高科学 提高质量
- 公共卫生 公共卫生
背景情况:
- 佛罗里达大学平等接入诊所网络 (EACN) 运营着佛罗里达州最大的由学生经营的免费诊所网络.
- 之前在Eastside诊所的中位患者访问时间为126.25分钟,这给患者带来了巨大的负担,特别是对于运输或安排限制的患者.
- 启动了一项持续质量改进 (CQI) 计划,以解决和减少患者访问时间.
研究的目的:
- 为了减少患者在Eastside诊所的总访问时间,EACN内的初级保健站点.
- 评估学生驱动的CQI项目的有效性,以优化诊所效率.
主要方法:
- 在六个月的时间内,实施了四个计划-做-研究-行动 (PDSA) 周期.
- 干预措施包括增加生命体的人员/空间,简化摄入量,根据复杂性和学生经验对患者进行分组,并实施"推动"干预措施以促进流动.
- 病人访问的长度和在每个阶段花费的时间都被匿名记录下来,平均访问长度每周跟踪一次.
主要成果:
- 在四个PDSA周期后,患者访问的中位数从126分钟减少到114分钟.
- 患者摄入时间的显著减少 (从19分钟到9分钟的中位数) 是整体减少的主要驱动因素.
- 访问长度的强烈下降趋势在第四个PDSA周期中变得明显.
结论:
- 一个由学生领导的CQI模型有效地减少了学生运营的免费诊所环境中的患者访问时间.
- 这些发现表明,类似的CQI模型可以应用于改善全国SRFC患者体验和效率.
- 优化特定的诊所流程,如患者接收,可以大幅改善整体访问时间.
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